RFI Browser

RFI # 1629:
Revenue Codes & Modifiers

Informal
Formal

Submitter

BCBSIL HCSC

Description

Would the following be a compliant use of the SVC segment using the SVC01-1 = NU ?

SVC*NU:0079:QK*2604*248.01****1~

It's our understanding that Revenue Codes do not have modifiers (SVC01-3) and that would indicate that an NU with a product/service ID and a modifier would be an invalid/incorrect use of the NU qualifier.

Is our understanding correct?

Submitter Assigned Keywords

Revenue Codes and Modifiers

Response

Modifiers apply to CPT and HCPCS Level II codes, which would be identified in the 005010X212, SVC01-01 with the qualifier ‘HC – Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes’. Modifiers are not reported with Revenue Codes as evidenced by the SV2 Segment of the 837 Institutional Guide. Since modifiers are not submitted in conjunction with Revenue Codes on the claim, it would be inaccurate and not consistent with the guide to report modifiers with a Revenue Code in the Claim Status Transaction.